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Application_1181926CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1181926 Applicant First Name Last Name Terry Willey Company Name Northwest Quality Remodel & Deck Number Street 15414 91 st AVE SE Apartment or Suite Number E-mail Address awhomes@comcast.net City State Zip Snohomish WA 98296 Phone Number Extension (360) 668-0191 Contractor Company Name NW QUALITY REMODEL & DECK LLC Number Street 15414 91 st AVE SE Apartment or Suite Number City State Zip Snohomish WA 98296 Phone Number Extension (360) 668-0191 State License Number License Expiration Date NWQUAQR898JL 4/13/2023 UBI # E-mail Address F;nil D?97S awhomes@comcast.net Project Location Number Street 21925 95TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00527900001600 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Claudia J Lafollette Number Street 21925 95TH AVE W Apartment or Suite Number City State EDMONDS WA Zip 98020 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent, including an appropriately licensed contractor. I have furnished true and correct information. I will comply with all provisions of law and ordinances governing this type of construction work, whether specific herein or not. By submitting this application I give the jurisdiction permission to enter the property to perform inspections. I understand that failure to comply with the above may result in revocation of the permit. Date Submitted: 8/2/2022 Submitted By: Terry Willey Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1181926 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Details Appliances and Equipment Gas Piping Outlets - Mech Work Location Work Description/Location (example: 1st floor, moving water heater and stove gas outlet locations Master Bath, Garage) Page 2 of 2